Statines et risque de diabète : quelles évidences ?

Statins are the most widely used lipid lowering drugs due to their proven efficacy to reduce cardiovascular events. Recent post-hoc analyses of randomized controlled trials demonstrated that statins are associated with an increased risk of developing type 2 diabetes (T2D). The risk is higher with high doses of statins and in people with pre-existing risk factors for T2D. Whether some statins are more diabetogenic than others remains a controversial issue. The underlying molecular mechanisms sustaining the diabetogenic action of statins remains largely unknown. From a clinical perspective, evidence suggest that the benefits of statins for the reduction of cardiovascular risk far outweigh the risk of developing T2D, especially in patients with higher cardiovascular risk. However, physicians should assess all patients for their T2D risk prior to starting statin therapy in order to reinforce lifestyle changes and to monitor glycemic parameters.